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- W2074445442 abstract "Recombinant factor VIIa (rFVIIa) is licensed for use in hemophilic patients with inhibitors. Non-hemophilic patients with uncontrolled hemorrhage, who have not responded to all available standard therapies, have been reported to respond to treatment with rFVIIa. These clinical observations have therefore led to the use of rFVIIa in a variety of other conditions with potentially impaired thrombin generation, with a resulting growing body of literature most often in the form of case reports and series. The response to rFVIIa in these patients may potentially be explained by the cell based mechanisms of action of rFVIIa. The use of rFVIIa in gastrointestinal (GI) bleeding refractory to conventional therapeutic interventions is reviewed in this report which includes diverse clinical situations representing liver disease, hematologic malignancies, bone marrow transplantation, platelet function disorders, Crohn's disease, peptic ulcer disease, and dengue hemorrhagic fever. In many cases patients were refractory to multiple therapeutic measures including standard hematologic and pharmacologic support, endoscopic and surgical interventions with administration of rFVIIa representing the only remaining option. Reported responses in these intractable situations have varied from temporary cessation of bleeding to complete response. Many patients were treated with multiple hemostatic agents concurrently with rFVIIa. There were no reported instances of disseminated intravascular coagulation or thrombotic events in the reviewed literature. Given the efficacy of rFVIIa noted in refractory settings, rFVIIa may prove to be a valuable hemostatic agent in standard first line therapy of GI bleeding, prior to development of hemostatic derangements. The efficacy and safety of rFVIIa as a single hemostatic agent in the setting of refractory GI hemorrhage and as part of standard first line therapy for GI hemorrhage are best evaluated in prospective randomized clinical trials. Several trials are currently in progress and are discussed here." @default.
- W2074445442 created "2016-06-24" @default.
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- W2074445442 date "2003-12-01" @default.
- W2074445442 modified "2023-09-26" @default.
- W2074445442 title "The Use of Recombinant Factor VIIa in Gastrointestinal Bleeding" @default.
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- W2074445442 doi "https://doi.org/10.1111/j.1778-428x.2003.tb00097.x" @default.
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